”GIMMICS: How to organize, manage

and control a pharmacy practice game”

Online Educa Berlin 2005

Speakers

Prof.dr. Jos van der Werf University of Groningen

Professor in Pharmacy Business Administration

j.j.van.der.werf@rug.nl

ir. Aaldrik Sillius

University of Groningen

Educational Technologist

a.w.sillius@rug.nl

GIMMICS=Pharmacy Practice Game

Outline of the presentation:

- GIMMICS: organization / management / control- experiences with GIMMICS (1998-2002)

- an emerging problem in controlling GIMMICS (2003) - how we tackled this problem (2004-2005)

- lessons learnt

GIMMICS: starting point

Considerations at the outset:

1) develop teaching provision to bring pharmacy practice into the educational setting

2) a game is a good choice for such a provision:- games create a rich educational setting- which is a prerequisite for teaching academic skills

3) the game must be as close to real life as possible- use real experts from the health care field- use actors

Game setting: physical

Headquarters

Room 1 Room 2 Room 3 Room 4 Room 5

ground floor

3rd floor

5-6 students

2 computers -> LAN / Internet

1 client: -> Pharmacom or Aposys a small library -> referential purposes

2 teachers, 2 student assistants

3 computers ->LAN / Internet

2 servers: Pharmacom / Aposys -> pharmacy computer systems

Game setting: communication

Headquarters

Room 1 Room 2 Room 3 Room 4 Room 5

ground floor

3rd floor

website* Pharmacom* Aposys

phone email face-to-face

Week 1: students prepare for the game

- familiarize with setting in “Pill Village” - virtual village

- define pharmacy policy- guidance for the rest of the game!

- set up documentation system- familiarize with pharmacy computer system- divide roles

- 1st/2nd pharmacist, pharmacy assistants

Game setting: in time (1/2)

Weeks 2,3,4: “Students … the game is on!”

- full responsibility for running their pharmacy- game management start providing assignments- each pharmacy starts with 8000 (virtual) patients- if pharmacies do well, they gain patients- if not, …..

Last day of the game- the team with the highest number of patients is the winner

Game setting: in time (2/2)

Assignments: 4 categories

Routine ~: Long term ~:

Ad-hoc ~:Self-defined projects

* specialize on: - polypharmacy - the elderly - travel* take over other pharmacy* cooperate with other pharmacy

negotiate with: - drug retailers - health insurance companies meet with: - local physicians - board of home for the elderly

daily processing of prescriptions

- Ntotal = 35-40

- Npitfalls=20-25

client needs inhaler instruction

physician: “Substitution allowed?”

drug addict: “I want methadon!”

woman speaking in foreign tongue

hospital specialist: “Pills too large!”

Assessment of assignments:- each assignment is assessed - assessment based on:

- solid evidence (processing of prescriptions)- on-the-job observations (e.g. during meetings)- feedback of actors/actresses

Outcome of assessment:- either gain or loose a number of patients

Assessment procedure (1/2)

Now this may come as a surprise ….

Assessment procedure (2/2)

Outcomes of assessments are not explained !!!- students have to reflect on their own actions

- as an individual- as a team

In practice:- difficult at first, both for students and teachers

Experiences with GIMMICS (1/2)

1998-2002: students state that playing GIMMICS ….

- is great fun

- makes them more prepared for their next internships

- invokes them to reflect on their own actions

- invokes them to integrate knowledge and skills they have acquired over the past few years

Experiences with GIMMICS (2/2)

Other universities followed our lead:

University of Utrecht Faculty of Pharmacy(have introduced GIMMICS in 2004)

University of BrusselsFaculty of Pharmacy(will introduce GIMMICS early 2006)

An emerging problem (2003)

External experts and actors:- are invited to supply case material from their own practice

Pro’s:- case material is up-to-date, realistic- keeps game dynamic- keeps students and experts motivated

Con’s:number of game interactions => information load => workload => number of mistakes

Analysis of game setting

Any solutions? (1/2)

Solution 1: take action- impose standards on case material Outcome:- external experts will loose motivation and leave- game setting will become poor

Solution 2: take no action- “Mistakes will happen”Outcome: - external experts will become discomforted and leave- game setting will become poor

Any solutions? (2/2)

Solution 3: - reduce the workload / information overload of the game management

How:- identify game activities that are time consuming - select those activities that can be

- foreseen - put in your own time schedule- facilitated through the use of ICT

Activity 1 (1/6)

Activity 1: planning and documentation of agenda’s of external experts and actors

- concerning long term assignments: “Is health care expert X available at day D?”

- concerning ad-hoc assignments: “Can actor A play role R in case C at day D?”

Activity 1 (2/6)

Solution: Actor Registration System

- internet application

- after registration, experts/actors provide info on:- contact information- actor profile- availablility

- game management use this info to:- schedule assignments

ARS: login screen (3/6)

ARS: actor profile (4/6)

ARS: actor availability (5/6)

ARS: selecting an actor (6/6)

Activity 2 (1/4)

Activity 2: storage and retrieval of case material

- case material from external experts / actors- digitally stored, but never processed

Problems:- troublesome retrieval

Activity 2 (2/4)

Solution: Case Management System

- internet application

- cases are described and stored in a structured format- meta-information is added

- retrieval made easy - possibility to share cases (->Groningen/Utrecht )

CAMS: login screen (3/4)

CAMS: editing a case (4/4)

Activity 3 (1/4)

Activity 3: transfer of knowledge from game management (GM) to student assistants (SA)

- SA support GM throughout the game- GM are experts in running the game- SA are novices- GM must transfer (implicit) game knowledge:

- facts, descriptions, criteria, manuals, procedures,…- rules of thumb, strategies

Activity 3 (2/4)

Solution: build a GIMMICS Knowledge Base

- make implicit game knowledge explicit- using techniques from knowledge engineering- describe knowledge as task models- task models are hierarchic by nature

- put hierarchy of task models into digital form- make them available to student assistants

GKB: a (partial) task model (3/4)

GKB: an elementary task (4/4)

ARS/CAMS/GKB: experiences

Built:- ARS (2004), CAMS (2004), GKB (2005):

Used:- in several game rounds in Groningen/Utrecht

Game management state: - very useful tools in reducing workload

- while preparing for the game- while running the game

- “Yes .... let’s think of new initiatives in the game”

Lessons learnt (1/2)

1) Starting premisseA game with a rich setting creates an appropriate educational environment for learning academic skills

2) Inevitable chain of events: richness of game setting => number of game interactions => workload => mistakes

3) Imposing standards is not an option number of standards => richness => motivation of all game participants

Lessons learnt (2/2)

4) There are better ways to reduce workload- carefully analyze all game interactions - identify time-consuming activities - select those that can be

- foreseen - put in your own time schedule- facilitated through ICT